I was recently notified that the state has taken over and all residents must relocate. My mom has dementia and gets easily agitated and has been bedridden for the past 9 months. I cannot find a nursing home that will take her due to behavioral problems. I cannot care for her as I am disabled and driving is a challenge. My mom is on Medicaid and it seems all facilities want are short-term residents, no long-term Medicaid, and definitely no one with any behavioral problems. What happens if I cannot find a place? The home is being run by a management company who is actively looking to place over 60 residents and have placed about half. I go to nursing homes and they give me a tour showing me empty beds until they learn my mom is coming from another home, will be long-term, and has Medicaid. Including her behavioral issues (she screams for someone when she's hungry or in pain as she cannot push the call button). Any insight on what's going to happen next? The management company says not to worry, but how can I not worry?!?!

6 Answers

How worrisome. Although you have transportation challenges, you can use the phone and internet to bridge the gap. Some suggestions to help keep mom's care and security on track:1.) Contact the ombudsman at mom's current SNF. Explain your concerns about the delay with mom's placement. If the ombudsman's answers are vague, tell him/her that you will call back in one week to check progress. And make good on that -- for as many weeks as you need to. Perhaps with help. See #2. 2.) Contact your county's agency on aging, explain mom's situation and request an advocate. As a Medicaid patient, mom qualifies for county and state-funded support for this involuntary transition. 3.) Make sure that your county/state contacts know that you are disabled. They need to understand that you cannot hop in the car and arrive at a meeting at someone else's convenience. All parties need to work for you and with you. 3.) Be firm and be persistent. Unfortunately, the first response from those who are supposed to help you might be a variant of "too busy." Keep pressing. Don't give up. If someone tries to give you the brush-off, do not let the conversation end until he/she provides contact info for his/her supervisor or another agency/office with expertise on your issue.

There must be a protocol in place to relocate residents in case of disasters like fire, flood, etc, at least there is where I live. By necessity the plan will include temporary accommodations or moving residents much farther away from their families, but no one will be left on the side of the road. In the mean time, keep searching.

Was the SNF shut down by the state due to the facility not proving care within guidelines/standards of care by the regulating state agency?If so then your mother is receiving less than optimal care to begin with and perhaps it is better to have her transferred. I would imagine they will eventually find placement in another SNF although I am not familiar with this situation. I feel so bad for your mom and her family being put in this precarious position. But again if the state regulatory body shut them down, the patients deserve better care elsewhere as usually the state will have given the facility many opportunities to get up to care standards- episodes like this don't occur without prior inspections being flawed and the facility cited for not providing care up to the state's standards. The facility on prior surveys was probably cited for poor care standards and had to present and implement plan of corrections to fix their issues and they did not follow through. Good luck to your mom and family. It may take time but I believe they are required to find the patient a bed at another center.

Moms7th - the responsibility falls to the NH so therefore falls to the management co. Medicaid rules requires a plan of placement. The NH was told of its deficiencies probably for years & did not do whatever needed to be accredited OR the owner of the facility wants it closed as they have bigger & better "plans" for the site. Whichever doesn't matter, it's their responsibility. They legally HAVE TO HAVE some sort of plan in place in case there is an evacuation due to a natural disaster or other emergency situation.

You may find that they are shape-shifting to try to have you to do this. Don't let them bully or otherwise pressure you to do this. I'd suggest you do a short 1 page letter to the management co that you are yourself handicapped and are unable to deal with the transitioning of your mom - a beloved resident of long, long standing at Shady Acres NH - to move from Shady Acres to become a SNF resident of whatever facility in the county (be sure name your county in the letter) before Shady closes. But to please reach out to you for any questions or concerns they have regarding your mom. Be sure to write in your moms full name and Medicaid ID # and the last 4 of her SS #. I'd even put in a line that if mom would be better in a hospice facility that would be an option you would support. Letters should be sent certified mail with the green Return Registered mail card from the USPO. Will cost about $8.00 and is considered legal if there's issues later on. If you have a fax # for the NH & the management co, then fax letter to each as well. For the fax you need to send it from a Fed Ex type of store that provides a "transmission report". Transmission report is proof that you did this. Fed Ex office 1page local maybe $2.00. Both provide proof that you as DPOA are aware of the situation but that it will their responsibility for placement of mom.

It needs to be on writing cause if not, somebody is going to tell their supervisor / boss that you told them verbally that you would be responsible. They will push it onto you.

As an aside on this.. Long but gets at what can happen & facility responsibility. 2004- back in mid Sept. 2004 Hurricane Ivan went through the entire Gulf coast, s...l...o..w moving. BUT before Ivan, FL & "LA" (lower Alabama) had already gotten affected by Charley & Frances & pretty massive power outages still existed. Plus stores were not yet back up & stocked. Gas stations unless they had a gennie had no way to pump gas out of the "well" as no power. Planning chaos. NH all along the Gulf were planning evacuations inland for Ivan but were finding that their supposed evacuation facility was also the facility for several others as well. So unless they arrived first, they were SOL on having a NH facility for their bus or van load of residents. Some NH had Charley & Francis displaced residents so no room. It was at the point that FL had NH residents moved into GA in emergency agreements between the states. So Ivan heading to Nola and NH realize there's an issue and start calling families to see if family will pick up Mom, grandpa, Auntie if theres a voluntary evacuation. We got a call as MIL in a NH in New Orleans, we declined as we knew staff was sheltering in place and MIL was not power dependent & we were staying too. But for those that went to the NH & picked up the elder, it became a total clusterF. The normally 2 hr drive NoLa to Baton Rouge morphed into 8 hrs and you could not exit off easily. Travel Nightmare & even more so with dementia mom in the backseat with your dog & very VERY unhappy cat. Then folks did not know how to deal with a skilled nursing needing elder; did not know how to ventilate upon a panic attack; did not know how to reposition to lessen pressure zones; did not know that mom only would take her meds if they were mixed in with grits so the yogurt / oatmeal / applesauce & RX blend tries got spit out or thrown back at family; did not realize that mom was used to a 2 person shower team and you could not do it solo; that mom needed a new depends every 3 hours...... Some had elder for a couple of weeks as had to wait an extra weekend to get someone to share the drive back to NOLA. And upon getting elder back to the NH, there was paperwork required to smooth out the suspended ineligibility for Medicaid as the elder was beyond 3 days gone automatic NH medicaid cancellation rules. Everbody I spoke with at MILs who took elder for Ivan, swore they would never ever do that again but 1did..... Then 2005, the next year, MILs NH sent out a letter to family contact as to evacuation rules & where the NH would move resident, etc. & within letter was a will/will not pick up box with required signature and SASE to return the form. If you checked will & didn't or did not return letter, it basically absolved the NH from any issues should something happen. Then Katrina came, now we stayed (Marigny) & her NH stayed (FrQtr). But we like her NH eventually left. NH moved into hotel in Houston. Those needing 24/7 power went into a freestanding hospice immediately & the rest all into a facility in TX on Medicaid within abt 3 weeks. If this can be done after the worst storm in history, well the management co has the ability to do this & it's their responsibility to deal with.

The NH is responsible to plan for & arrange for placement in a comparable that meets the needs of the resident. Louisiana has a state-mandated emergency plan. For my MIL, her NH did everything it could to get residents out, resettled. But the residents whose family came & picked them up, they had to do everything on thier own to find a Nh post Katrina & it was much much worse than after Ivan as there as no way to get old records to show care needs to start with....Really Moms7th..... You have got to make the "management group" aware that you know it's their responsibility to do whatever is needed to find a facility for your mom. Don't let your emotion come into play & you go and get her. Good luck & stay resilient.

Great tips everyone, this must be very scary. Both my parents are in a nursing home in the same room. I can see my dad making trouble so no one would take him. Good luck and I pray the state helps you out.

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